Kidney transplantation in systemic sclerosis: Advances in graft, disease, and patient outcome
Systemic sclerosis (SSc) is an immune-mediated rheumatic disease characterized by vascular abnormalities, tissue fibrosis, and inflammation. Renal disease occurring in patients with SSc may have a variable clinicopathological picture. However, the most specific renal condition associated with this d...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-07-01
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| Series: | Frontiers in Immunology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fimmu.2022.878736/full |
| _version_ | 1818002335651069952 |
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| author | Federica Maritati Michele Provenzano Sarah Lerario Valeria Corradetti Claudia Bini Marco Busutti Valeria Grandinetti Vania Cuna Gaetano La Manna Giorgia Comai |
| author_facet | Federica Maritati Michele Provenzano Sarah Lerario Valeria Corradetti Claudia Bini Marco Busutti Valeria Grandinetti Vania Cuna Gaetano La Manna Giorgia Comai |
| author_sort | Federica Maritati |
| collection | DOAJ |
| description | Systemic sclerosis (SSc) is an immune-mediated rheumatic disease characterized by vascular abnormalities, tissue fibrosis, and inflammation. Renal disease occurring in patients with SSc may have a variable clinicopathological picture. However, the most specific renal condition associated with this disease is the scleroderma renal crisis (SRC), characterized by acute onset of renal failure and severe hypertension. SRC develops in about 20% of cases of SSc, especially in those patients with diffuse cutaneous disease. The prognosis of this condition is often negative, with a rapid progression to end-stage renal disease (ESRD). The advent of the antihypertensive angiotensin-converting enzyme inhibitors in 1980 was associated with a significant improvement in patients’ survival and recovery of renal function. However, the prognosis of these patients can still be improved. The dialytic condition is associated with early death, and mortality is significantly higher than among patients undergoing renal replacement therapy (RRT) due to other conditions. Patients with SRC who show no signs of renal functional recovery despite timely blood pressure control are candidates for kidney transplantation (KT). In this review, we reported the most recent advances in KT in patients with ESRD due to SSc, with a particular overview of the risk of disease recurrence after transplantation and the evolution of other disease manifestations. |
| first_indexed | 2024-04-14T03:44:43Z |
| format | Article |
| id | doaj.art-fa9db2098b184fe79a09158de9445d1c |
| institution | Directory Open Access Journal |
| issn | 1664-3224 |
| language | English |
| last_indexed | 2024-04-14T03:44:43Z |
| publishDate | 2022-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Immunology |
| spelling | doaj.art-fa9db2098b184fe79a09158de9445d1c2022-12-22T02:14:21ZengFrontiers Media S.A.Frontiers in Immunology1664-32242022-07-011310.3389/fimmu.2022.878736878736Kidney transplantation in systemic sclerosis: Advances in graft, disease, and patient outcomeFederica MaritatiMichele ProvenzanoSarah LerarioValeria CorradettiClaudia BiniMarco BusuttiValeria GrandinettiVania CunaGaetano La MannaGiorgia ComaiSystemic sclerosis (SSc) is an immune-mediated rheumatic disease characterized by vascular abnormalities, tissue fibrosis, and inflammation. Renal disease occurring in patients with SSc may have a variable clinicopathological picture. However, the most specific renal condition associated with this disease is the scleroderma renal crisis (SRC), characterized by acute onset of renal failure and severe hypertension. SRC develops in about 20% of cases of SSc, especially in those patients with diffuse cutaneous disease. The prognosis of this condition is often negative, with a rapid progression to end-stage renal disease (ESRD). The advent of the antihypertensive angiotensin-converting enzyme inhibitors in 1980 was associated with a significant improvement in patients’ survival and recovery of renal function. However, the prognosis of these patients can still be improved. The dialytic condition is associated with early death, and mortality is significantly higher than among patients undergoing renal replacement therapy (RRT) due to other conditions. Patients with SRC who show no signs of renal functional recovery despite timely blood pressure control are candidates for kidney transplantation (KT). In this review, we reported the most recent advances in KT in patients with ESRD due to SSc, with a particular overview of the risk of disease recurrence after transplantation and the evolution of other disease manifestations.https://www.frontiersin.org/articles/10.3389/fimmu.2022.878736/fullsystemic sclerosisscleroderma renal crisisACE inhibitorsrenal replacement therapykidney transplant |
| spellingShingle | Federica Maritati Michele Provenzano Sarah Lerario Valeria Corradetti Claudia Bini Marco Busutti Valeria Grandinetti Vania Cuna Gaetano La Manna Giorgia Comai Kidney transplantation in systemic sclerosis: Advances in graft, disease, and patient outcome Frontiers in Immunology systemic sclerosis scleroderma renal crisis ACE inhibitors renal replacement therapy kidney transplant |
| title | Kidney transplantation in systemic sclerosis: Advances in graft, disease, and patient outcome |
| title_full | Kidney transplantation in systemic sclerosis: Advances in graft, disease, and patient outcome |
| title_fullStr | Kidney transplantation in systemic sclerosis: Advances in graft, disease, and patient outcome |
| title_full_unstemmed | Kidney transplantation in systemic sclerosis: Advances in graft, disease, and patient outcome |
| title_short | Kidney transplantation in systemic sclerosis: Advances in graft, disease, and patient outcome |
| title_sort | kidney transplantation in systemic sclerosis advances in graft disease and patient outcome |
| topic | systemic sclerosis scleroderma renal crisis ACE inhibitors renal replacement therapy kidney transplant |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2022.878736/full |
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